|
Ghs paravert facet/nerve cerv ea add bil
|
$341.06 |
$341.06 |
$341.06 |
$855.60
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$1,815.08 |
$1,815.08 |
$1,815.08 |
$1,003.00
|
|
Ghs picc line insert < 5
|
$2,754.73 |
$2,754.73 |
$2,754.73 |
$2,060.40
|
|
Ghs plt ct-manual
|
$42.64 |
$42.64 |
$42.64 |
$39.20
|
|
Ghs ppd (tb intradermal)
|
$9.93 |
$9.93 |
$9.93 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$6.87 |
$6.87 |
$6.87 |
$40.56
|
|
Ghs protoporphyrins fract
|
$30.90 |
$30.90 |
$30.90 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$69.50 |
$69.50 |
$69.50 |
$156.70
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$7.05 |
$7.05 |
$7.05 |
$45.05
|
|
Ghs respiratory syncytical virus igg/m
|
$163.52 |
$163.52 |
$163.52 |
$42.40
|
|
Ghs reticulocyte count
|
$7.01 |
$7.01 |
$7.01 |
$33.57
|
|
Ghs rsv eia (respir synctial vrs)
|
$24.53 |
$24.53 |
$24.53 |
$101.15
|
|
Ghs sedimentation rate
|
$5.84 |
$5.84 |
$5.84 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$53.73 |
$53.73 |
$53.73 |
$59.90
|
|
Ghs somatosensory testing upper & lower limbs
|
$1,307.00 |
$1,307.00 |
$1,307.00 |
$1,435.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$117.39 |
$117.39 |
$117.39 |
$93.75
|
|
Ghs tracheostomy emergency - transtracheal
|
$2,570.19 |
$2,570.19 |
$2,570.19 |
$2,225.73
|
|
Ghs urine, porphyrins quant
|
$15.19 |
$15.19 |
$15.19 |
$70.20
|
|
Ghs veeg 12-26 hr intmt mont
|
$934.99 |
$934.99 |
$934.99 |
$1,843.00
|
|
Gi inhouse confirmation
|
$88.19 |
$88.19 |
$88.19 |
$87.00
|
|
Glucagon 1 mg solution for injection
|
$1,131.80 |
$1,131.80 |
$1,131.80 |
$613.00
|
|
Glucagon plasma - sendout
|
$11.67 |
$11.67 |
$11.67 |
$58.56
|
|
Glucose 1 hr post dose
|
$78.26 |
$78.26 |
$78.26 |
$46.28
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$56.65 |
$56.65 |
$56.65 |
$22.00
|
|
Glucose blood quantitative
|
$111.55 |
$111.55 |
$111.55 |
$44.76
|
|
Glucose body fluid
|
$133.74 |
$133.74 |
$133.74 |
$50.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$115.05 |
$115.05 |
$115.05 |
$100.10
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$44.97 |
$44.97 |
$44.97 |
$34.45
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$4,443.66 |
$4,443.66 |
$4,443.66 |
$56.70
|
|
Golimumab 12.5 mg/ml intravenous solution
|
$3,358.00 |
$3,358.00 |
$3,358.00 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$26.28 |
$26.28 |
$26.28 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$25.70 |
$25.70 |
$25.70 |
$123.75
|
|
Goserelin 10.8 mg subcutaneous implant
|
$3,358.00 |
$3,358.00 |
$3,358.00 |
$2,802.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$2,901.32 |
$2,901.32 |
$2,901.32 |
$2,648.81
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$23,801.51 |
$23,801.51 |
$23,801.51 |
$25,762.70
|
|
Graft nerve adv 3-4x70mm
|
$26,181.89 |
$26,181.89 |
$26,181.89 |
$27,495.00
|
|
Graft patch felt ptfe 2x2
|
$18,229.56 |
$18,229.56 |
$18,229.56 |
$25,728.84
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$14,021.84 |
$14,021.84 |
$14,021.84 |
$1,560.21
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$6,380.20 |
$6,380.20 |
$6,380.20 |
$2,369.10
|
|
Graft tis hmatrix dermis 10x5 -cost per sq cm
|
$1,319.26 |
$1,319.26 |
$1,319.26 |
$3,431.03
|
|
Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm
|
$28,799.96 |
$28,799.96 |
$28,799.96 |
$35,824.13
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$2,901.32 |
$2,901.32 |
$2,901.32 |
$3,070.00
|
|
Graft xenmtrx sft rect 15x20cm
|
$46,381.28 |
$46,381.28 |
$46,381.28 |
$43,312.93
|
|
Graft xenmtrx sft rect 19x28cm
|
$1,319.26 |
$1,319.26 |
$1,319.26 |
$2,653.10
|
|
Granisetron hcl injection
|
$261.05 |
$261.05 |
$261.05 |
$41.65
|
|
Granulocyte pheresis ea unit
|
$2,037.00 |
$2,037.00 |
$2,037.00 |
$2,950.30
|
|
Growth hormone antibody
|
$69.56 |
$69.56 |
$69.56 |
$40.00
|
|
Guided cath fluid drainage 10030
|
$306.60 |
$306.60 |
$306.60 |
$1,461.15
|
|
Guide wire threaded 1.4x150mm
|
$2,230.88 |
$2,230.88 |
$2,230.88 |
$3,474.86
|
|
Guide worley csg 9fx50cm std
|
$1,715.80 |
$1,715.80 |
$1,715.80 |
$2,229.99
|
|
Gw stiffened micro access kit
|
$3,773.23 |
$3,773.23 |
$3,773.23 |
$6,285.56
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$68.92 |
$68.92 |
$68.92 |
$35.40
|
|
Haptoglobin quantitative
|
$27.62 |
$27.62 |
$27.62 |
$89.95
|
|
Hba1/hba2 full gene sequence
|
$273.02 |
$273.02 |
$273.02 |
$777.60
|
|
Hba1/hba2 gene dup/del vrnts
|
$204.40 |
$204.40 |
$204.40 |
$406.25
|
|
Hbb full gene sequence
|
$525.60 |
$525.60 |
$525.60 |
$633.25
|
|
Hbb gene dup/del variants
|
$269.11 |
$269.11 |
$269.11 |
$404.80
|
|
Hbot, full body chamber, 30m
|
$383.11 |
$383.11 |
$383.11 |
$494.40
|
|
Hcg qualitative
|
$165.86 |
$165.86 |
$165.86 |
$77.50
|
|
Hcg quantitative
|
$207.91 |
$207.91 |
$207.91 |
$124.80
|
|
Hc i-131 sodium iodide cap dx per mci
|
$29.20 |
$29.20 |
$29.20 |
$136.50
|
|
Head CT scan (with and without contrast)
|
$4,220.57 |
$4,220.57 |
$4,220.57 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$3,581.09 |
$3,581.09 |
$3,581.09 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$2,557.92 |
$2,557.92 |
$2,557.92 |
$1,268.90
|
|
Helicobacter pylori antibody igm
|
$177.54 |
$177.54 |
$177.54 |
$84.80
|
|
Hematocrit
|
$61.32 |
$61.32 |
$61.32 |
$33.57
|
|
Hemodialysis one evaluation
|
$1,167.42 |
$1,167.42 |
$1,167.42 |
$1,329.90
|
|
Hemoglobin
|
$61.91 |
$61.91 |
$61.91 |
$31.75
|
|
Hemoglobin plasma
|
$8.18 |
$8.18 |
$8.18 |
$40.56
|
|
Hemoglobin urine
|
$8.95 |
$8.95 |
$8.95 |
$23.31
|
|
Hemolysins/agglutinins auto
|
$55.19 |
$55.19 |
$55.19 |
$53.90
|
|
Hemolysins and agglutinins incubated
|
$37.08 |
$37.08 |
$37.08 |
$67.50
|
|
Heparin assay
|
$119.14 |
$119.14 |
$119.14 |
$130.20
|
|
Heparin bolus from bag
|
$43.22 |
$43.22 |
$43.22 |
$79.04
|
|
Heparin neutralization
|
$17.99 |
$17.99 |
$17.99 |
$47.45
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$26.87 |
$26.87 |
$26.87 |
$32.27
|
|
Hepatitis a antibody igm
|
$4.68 |
$4.68 |
$4.68 |
$85.15
|
|
Hepatitis b core antibody igm
|
$5.84 |
$5.84 |
$5.84 |
$87.98
|
|
Hepatitis b core antibody total
|
$3.51 |
$3.51 |
$3.51 |
$83.29
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$2,723.20 |
$2,723.20 |
$2,723.20 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$5.84 |
$5.84 |
$5.84 |
$83.79
|
|
Hepatitis c antibody
|
$277.99 |
$277.99 |
$277.99 |
$108.00
|
|
Hepatitis d quantification
|
$115.64 |
$115.64 |
$115.64 |
$145.06
|
|
Hepatobiliary system imaging
|
$1,870.56 |
$1,870.56 |
$1,870.56 |
$1,521.10
|
|
Hereditary colon ca dsordrs
|
$1,309.62 |
$1,309.62 |
$1,309.62 |
$1,956.00
|
|
Herpes simplex 1 ag if
|
$21.18 |
$21.18 |
$21.18 |
$40.28
|
|
Herpes simplex 2 ag if
|
$21.19 |
$21.19 |
$21.19 |
$40.77
|
|
Herpes simplex type 1 antibody igg
|
$12.92 |
$12.92 |
$12.92 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$12.92 |
$12.92 |
$12.92 |
$87.10
|
|
Herpes simplex virus isolation
|
$14.59 |
$14.59 |
$14.59 |
$93.32
|
|
Heterophile antibodies screening
|
$100.45 |
$100.45 |
$100.45 |
$73.60
|
|
Hexa gene
|
$133.30 |
$133.30 |
$133.30 |
$179.04
|
|
Hhv-6 dna quant
|
$43.80 |
$43.80 |
$43.80 |
$200.25
|
|
Histamine
|
$14.09 |
$14.09 |
$14.09 |
$125.40
|
|
Histochemical stains add-on
|
$204.64 |
$204.64 |
$204.64 |
$169.65
|
|
Hla class i high defin qual
|
$189.80 |
$189.80 |
$189.80 |
$574.86
|
|
Hla class i&ii antibody qual
|
$154.76 |
$154.76 |
$154.76 |
$207.60
|
|
Hla class i semiquant panel
|
$146.00 |
$146.00 |
$146.00 |
$697.50
|
|
Hla ii typing 1 loc hr
|
$143.08 |
$143.08 |
$143.08 |
$323.40
|
|
Hla i low res one antigen equiv ea
|
$113.88 |
$113.88 |
$113.88 |
$164.00
|
